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The Acute Phase Response and Exercise: Court and Field Sports

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The Acute Phase Response and Exercise: Court and Field Sports 170 Br J Sports Med 2001;35:170–173 The acute phase response and exercise: court and Br J Sports Med: first published as 10.1136/bjsm.35.3.170 on 1 June 2001. Downloaded from field sports K E Fallon, S K Fallon, T Boston Abstract capacity, and transferrin, and transferrin satu- Objective—To determine the presence or ration.45 absence of an acute phase response after A number of studies have documented training for court and field sports. aspects of the acute phase response after exer- Participants—All members of the Aus- cise of a duration that would be expected to tralian women’s soccer team (n = 18) and induce significant damage to skeletal 6–12 all members of the Australian Institute of muscle. No data are available on the acute Sport netball team (n = 14). phase response in relation to court and field Methods—Twelve acute phase reactants sports. (white blood cell count, neutrophil count, Documentation of the extent and nature of platelet count, serum iron, ferritin, and the acute phase response to various types of transferrin, percentage transferrin satu- exercise is important, as changes related to the response may need to be taken into account for ration, á1 antitrypsin, caeruloplasmin, á2 acid glycoprotein, C reactive protein, and interpretation of haematological and biochemi- erythrocyte sedimentation rate) were cal measurements made during and after participation in sport. measured during a rest period and after The aim of this prospective study was there- moderate and heavy training weeks in fore to determine the presence or absence of members of elite netball and women’s the acute phase response in sports representa- soccer teams. tive of a wide range of field and court sports. Results—Responses consistent with an acute phase response were found in five of 24 tests in the soccer players, and in three Methods of 24 tests in the netball players. Re- All procedures conformed to the National sponses in the opposite direction were Health and Medical Research Council guide- found in seven of 24 tests in the soccer lines for experimentation with human subjects players and two of 24 tests in the netball- and all subjects gave their written informed ers. The most sensitive reactant consent before participation in the study. measured, C reactive protein, did not The subjects were all members of the http://bjsm.bmj.com/ respond in a manner typical of an acute Australian women’s soccer team (n = 18) or the phase response. Australian Institute of Sport netball team (n = Conclusion—An acute phase response 14). As it is diYcult to assess elite athletes in an does not seem to occur as a consequence absolutely rested condition, the pretraining of the levels of training typical of elite blood sample was taken from the netball group female netball and soccer teams. This has on their return from summer vacation before implications for the interpretation of bio- they started routine training, and from the soc- chemical variables in these groups. cer group after they had taken a two week break on September 28, 2021 by guest. Protected copyright. (Br J Sports Med 2001;35:170–173) from routine training. The second soccer sam- ple was taken after five months of training dur- Keywords: acute phase response; iron; plasma proteins; ing a week selected by the coach as a moderate inflammation training week, and the third sample was taken nine months from baseline after a week selected by the coach as a heavy training week. Department of Sports The acute phase response is a common The second netball sample was taken after five Medicine, Australian reaction to a range of threats to homoeostasis Institute of Sport, months of training during a week selected by including bacterial infection, surgery, burns, the coach as a hard training week, and the third Belconnen, ACT, neoplasia, tissue infarction, inflammatory dis- Australia 1 2 sample was taken nine months from baseline K E Fallon eases, and prolonged exercise. The response after a week selected by the coach as a moder- S K Fallon includes metabolic changes such as negative ate training week. Duration and type of training nitrogen balance, changes in lipid metabolism, in each of the seven days before blood Department of alterations in serum concentrations of cations, Physiology collection was determined by athlete question- T Boston changes in iron metabolism, leucocytosis, com- naire and review of coaching records. plement activation, and increases in proteins Soccer training consisted of running, cy- Correspondence to: primarily produced in the liver.3 Concentra- cling, weight training, and training on the soc- Associate Professor Fallon, tions of albumin, transthyretin, á fetoprotein, Department of Sports cer pitch. In the week considered to be moder- Medicine, Australian á2 acid glycoprotein, and transferrin decrease ate training, mean duration of training was Institute of Sport, PO Box during the response. Changes related to iron 12.9 hours, and, in the intense training week, it 176, Belconnen, ACT 2616, metabolism also occur, including increased tis- was 9.3 hours. Netball training consisted of Australia sue storage iron (increased serum ferritin) and weight training, court work, and practice Accepted 29 January 2001 decreased serum iron, total iron binding games. In the week considered to be moderate www.bjsportmed.com Acute phase response and exercise 171 Table 1 Subject characteristics Serum iron, transferrin, ferritin, total iron Br J Sports Med: first published as 10.1136/bjsm.35.3.170 on 1 June 2001. Downloaded from binding capacity, percentage transferrin satura- Netball Soccer tion, creatine kinase activity, and haptoglobin Age (years) 18.4 (0.8) 23.0 (5.0) were measured on a Hitachi 911 analyser using Height (cm) 179.5 (7.1) 167.7 (7.9) Boehringer-Mannheim reagents. C reactive Weight (kg) 70.7 (10.6) 61.9 (7.1) protein, á1 antitrypsin, and á2 acid glycoprotein Values are means (SD). were measured by nephelometry on a Beck- mann Array Protein System (Beckmann, Brea, California, USA) using Beckmann reagents. training, mean duration of training was 10.5 Erythrocyte sedimentation rate (ESR) was hours, and, in the intense training week, it was measured using standard manual methods. 10.3 hours. All dependent variables were analysed using Exclusion criteria included the presence of a two tailed Student’s t test for diVerences from an acute or chronic inflammatory disease, resting levels. Statistical analysis was per- infection, or injury and use of anti- formed using Statistica, version 5.1 (StatSoft inflammatory medication or supplements con- Inc, Tulsa, Arizona, USA). taining iron. On three occasions, 20 ml blood was drawn Results from an antecubital vein, using a sterile Table 1 shows the characteristics of the technique, immediately after the subject had subjects. laid down. Samples were immediately trans- In the soccer group, 13 subjects reported no ferred to a laboratory adjacent to the blood training in the 72 hours before the start of the study, three had trained lightly up to 48 hours collection area and were processed within 60 before the start, and two had trained lightly minutes. All samples were obtained between 8 within 48 hours of the baseline measurements. am and 9 am. In the netball group, no subject had performed Table 2 Acute phase reactants in netball players any training within 72 hours of baseline meas- urements. In this group, mean (SD) total train- Variable Resting Heavy training Moderate training ing time during the week before baseline was 3 White cell count (× 109/l) 6.37 (1.23) 6.64 (1.10) 7.38 (1.26) (0.6) hours. Table 2 summarises the findings Neutrophil count (× 109/l) 3.22 (0.68) 3.30 (0.75) 3.98 (1.22) for acute phase reactants in the netball players. Platelet count (× 109/l) 217 (36) 229 (57) 229 (56) ESR had decreased after both heavy and mod- ESR (mm/1st h) 12 (6) 6.6 (3.8)* 8.1 (4.7)* C reactive protein (mg/l) 2.33 (1.21) 2.52 (0.68) 1.66 (0.89) erate training weeks. Serum caeruloplasmin Caeruloplasmin (g/l) 0.441 (0.154) 0.521 (0.172) 0.545 (0.179)* and á1 antitrypsin had increased after the mod- á1 antitrypsin (g/l) 1.65 (0.36) 1.83 (0.31) 1.85 (0.29)* erate training week. á acid glycoprotein (mg/dl) 82.9 (17.4) 89.8 (21.0) 99.2 (31.2) 2 Table 3 summarises the findings for iron Values are means (SD). related variables and creatine kinase activity in *p<0.05 v resting (two tailed Student’s t test). the netball players. No significant changes were ESR, Erythrocyte sedimentation rate. found in these variables. http://bjsm.bmj.com/ Table 3 Iron related variables and creatine kinase activity in netball players Table 4 gives the findings for acute phase reactants in the female soccer players. After the Variable Resting Heavy training Moderate training heavy training week, white cell count had Iron (mmol/l) 16.9 (6.6) 18.8 (6.3) 19.8 (7.8) decreased and á1 antitrypsin had increased, Ferritin (ng/ml) 53.6 (39.7) 42.9 (28.8) 38.2 (26.1) and after the moderate training week, signifi- Transferrin (g/l) 3.19 (0.53) 3.54 (0.53) 3.78 (0.47) Transferrin satn (%) 24 (10) 24 (9) 23 (10) cant decreases were found in the white cell Creatine kinase (U/l) 180 (132) 208 (90) 145 (69) count, neutrophil count, platelet count, C on September 28, 2021 by guest. Protected copyright. reactive protein, caeruloplasmin, and á2 acid Values are means (SD). glycoprotein. Table 4 Acute phase reactants in women soccer players Table 5 summarises the findings for iron related variables and creatine kinase activity in Variable Resting Moderate training Heavy training the female soccer players.
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